Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 2001-00129 | NC |
NPI | 1013900216 |
---|---|
Provider Name | Gary Paul Cram JR. |
First Address | Charlotte, NC 28204-3109 |
Second Address | Greensboro, NC 27401-1038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 14/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89128WT | (05) | NC |
H36946 | (02) | NC |